Carfilzomib (Kyprolis®)

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About This Drug

Carfilzomib is used to treat cancer. It is given in the vein (IV).

Possible Side Effects

  • A decrease in the number of red blood cells. This may make you tired and weak.
  • A decrease in the number of platelets. This may raise your risk of bleeding.
  • Tiredness
  • Nausea
  • Loose bowel movements (diarrhea)
  • Fever
  • Cough and trouble breathing
  • Headache
  • Swelling of your legs, ankles, and/or feet

Note: Each of the side effects above was reported in 20% or greater of patients treated with carfilzomib. Not all possible side effects are included above.

Warnings and Precautions

  • Congestive heart failure and/or heart attack which rarely could be life-threatening. You may be short of breath. Your arms, hands, legs and feet may swell.
  • Changes in your kidney function which can very rarely cause kidney failure
  • Tumor lysis: This drug may act on the cancer cells very quickly. This may affect how your kidneys work. Tumor lysis can be life-threatening.
  • Inflammation (swelling) of the lungs or fluid build-up in your lungs.  In rare cases respiratory failure has resulted, which can be life-threatening. You may have a dry cough or trouble breathing which may be severe.
  • High blood pressure in arteries of the lungs can very rarely occur.
  • High blood pressure, which can very rarely be life-threatening.
  • Blood clots and events such as heart attack.  A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain. Women should discuss choice of contraception and risk of blood clots with their medical team.
  • While you are getting this drug in your vein (IV), you may have a reaction to the drug. Sometimes you may be given medication to stop or lessen these side effects. Your nurse will check you closely for these signs: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain. These reactions may happen after your infusion.  If this happens, call 911 for emergency care.
  • Abnormal bleeding which can very rarely be life-threatening– symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
  • Severe decrease in platelets which can increase your risk of bleeding.
  • Rare blood vessels disorder called thrombotic microangiopathy which can affect some of your organs in your body such as your kidneys. This can rarely be life-threatening.
  • Changes in your liver function which can very rarely cause liver failure which can rarely be life-threatening.
  • Increased risk of toxicity or life-threatening events when used in combination with specific chemotherapy agents when used in patients who are not eligible for transplant.
  • Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, and coma. If you start to have any of these symptoms let your doctor know right away.

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.
  • Infusion reactions may occur after your infusion. If this happens, call 911 for emergency care.

Food and Drug Interactions

  • There are no known interactions of carfilzomib with food and with other medications.
  • Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Coughing up yellow, green, or bloody mucus
  • Wheezing or trouble breathing
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools ( bright red, or black/tarry)
  • Coughing up blood
  • A headache that does not go away
  • Blurry vision or other changes in eyesight
  • Your leg or arm is swollen, red, warm and/or painful
  • Confusion and/or agitation
  • Hallucinations
  • Trouble understanding or speaking
  • Numbness or lack of strength to your arms, legs, face, or body
  • Signs of infusion reaction: fever or shaking chills, flushing, facial swelling, feeling dizzy, headache, trouble breathing, rash, itching, chest tightness, or chest pain
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Decreased urine, or very dark urine
  • Nausea that stops you from eating or drinking  and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Weight gain of 5 pounds in one week (fluid retention)
  • Pain that does not go away or is not relieved by prescribed medicine
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 1 month after treatment. Men with female partners of child bearing potential should use effective methods of birth control during your cancer treatment and for at least 3 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: It is not known if this drug passes into breast milk.  For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: This drug is not expected to affect your ability to have children in the future. Human fertility studies have not been done with this drug.

Revised December 2017

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.